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Abstract
Systemic lupus erythematosus (SLE) is a systemic disease with cardiac manifestations, of which pericarditis is the most common (a lifetime risk of 25%)1 and myocarditis a less common (5–10%)2 but more severe manifestation. Both may occur in flares. Sometimes the cardiac presentation of pericarditis or myocarditis is the first presentation of lupus, therefore any presentation of pericarditis or myocarditis should be followed up with appropriate serology testing for SLE. A lupus myocarditis can be a severe presentation, necessitating circulatory support. Additional investigations are necessary and include cardiac magnetic resonance imaging2 3 and often a myocardial biopsy revealing a typical lymphocytic infiltration.4 A case will be presented. Therapy consisted of 3 days of high dose prednisolone, followed by cyclophosphamide in combination with prednisolone, followed by anti-TNF-α blockade.5
References
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Mavrogeni S, Bratis K, Markussis V, et al. The diagnostic role of cardiac magnetic resonance imaging in detecting myocardial inflammation in systemic lupus erythematosus. Differentiation from viral myocarditis. Lupus. 2013;22(1):34–43. doi: 10.1177/0961203312462265.
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Learning Objectives At the end of this presentation participants will be able to:
Differentiate between pericarditis and myocarditis as presenting features of SLE
Explain the importance of serological testing for SLE in patients with suspected pericarditis or myocarditis
Discuss the role of cardiac MRI and myocardial biopsy in diagnosing lupus myocarditis
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